Patient selection:
(1) generally adherent to the treatment regimen
(2) other conditions excluded
(3) exacerbating factors have been identified and treated
Major criteria:
(1) oral corticosteroids taken >= 50% of previous year (near continuous or continuous)
(2) requires high dose inhaled corticosteroid therapy (see previous section)
Minor criteria:
(1) requires daily controller medication in addition to inhaled corticosteroids
(2) requires short-acting beta-agonist on daily or near daily basis to control symptoms
(3) has persistent airway obstruction
(4) >= 1 urgent or emergency care visits for asthma in the past year
(5) >= 3 steroid "bursts" in the past year
(6) clinical deterioration shortly after any attempt to reduce oral or inhaled corticosteroid dose by <= 25% (steroid dependent)
(7) >= 1 near fatal asthma event in the past
where:
• Persistent airway obstruction was defined as FEV1 less than 80% of predicted AND diurnal peak expiratory flow (PEF) variability > 20%.
• Daily controller medications include a long acting beta-agonist, theophylline, or a leukotriene antagonist.
Diagnosis of refractory anemia requires both of the following:
(1) at least 1 major criterion
(2) at least 2 minor criteria
